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Annals of Clinical and Experimental Metabolism

Association between Lifestyle Habits Questionnaire and Plasma Free Amino Acid Profile in Japanese Rural Community Dwellers

Research Article | Open Access Volume 3 | Issue 2 |

Corresponding Authors
Abstract

The plasma free amino acid (PFAA) profiles are demonstrated to be altered by overnutrition and subsequent insulin resistance, and/or protein malnutrition in generally healthy subjects. Although, the measurement of PFAAs to evaluate the risk of overnutrition and protein malnutrition is potentially useful, large scale social implementation present several difficulties. Currently, rigorous measurement of PFAAs using high-performance liquid chromatography–electrospray ionization mass spectrometry, following the collection of fasting blood in the morning in hospitals with strict sample management, is required, which can be a burden for local hospitals. In this study, we designed a simple lifestyle habits questionnaire consisting of 19 questions reported to be associated with overnutrition and protein malnutrition, suitable for Japanese rural communities. And then, we investigated the association between PFAAs and the results of the questionnaire in 1,764 Japanese local community dwellers. The results of questions regarding lifestyles leading to overnutrition and subsequent body weight gain were associated with higher concentrations of most essential amino acids including branched chain amino acids and aromatic amino acids. On the other hand, results of questions related to lifestyles leading to protein malnutrition were associated with lower concentrations of some essential amino acids. The results of questions regarding sleep duration, frequency of dairy food intake, snack habit, gait speed, fruit and vegetable intake had little impact on PFAA profiles. This simple lifestyle habits questionnaire could be a potential screening tool to predict alterations of PFAA profiles. Further validations of the associations with other populations are necessary before large scale social implementation.

Keywords

• Plasma free amino acid • Lifestyle habits • Overnutrition • Protein malnutrition

ABBREVIATIONS

PFAAs: Plasma Free Amino Acids; BCAAs: Branched-Chain Amino Acids; AAAs: Aromatic Amino Acids; Ala: Alanine; Arg: Arginine; Asn: Asparagine; Cit: Citrulline; Glu: Glutamate; Gln: Glutamine; Gly: Glycine; His: Histidine; Ile: Isoleucine; Leu: Leucine; Lys: Lysine; Met: Methionine; Orn: Ornithine; Phe: Phenylalanine; Pro: Proline; Ser: Serine; Thr: Threonine; Trp: Tryptophan; Tyr: Tyrosine; Val: Valine; αABA: α-Amino Butyric Acid; SE: Standard Error; SPRC: Standardized Partial Regression Coefficients; 2Na·EDTA: Disodium Ethylenediaminetetraacetate

INTRODUCTION

Recently, accumulating evidence has revealed that the concentrations of plasma free amino acids (PFAAs) are potential biomarkers for overnutrition and subsequent insulin resistance [1-3], and/or protein malnutrition [4-6]. Among the PFAAs, especially branched-chain amino acids (BCAAs) and aromatic amino acids (AAAs), are associated with visceral obesity, insulin resistance, and diabetes mellitus in several cross-sectional and prospective cohort studies [1,7-10]. BCAA concentrations are elevated in obese humans and animal models [9,11,12]. This elevation is caused by insulin resistance which decreases utilization of amino acids and uptake of BCAAs into muscles [13,14]. Furthermore, insulin resistance decreases expression of adipose-tissue BCAA catabolizing enzymes, leading to decreased BCAA metabolism in visceral adipose tissue [13,15,16]. Other plasma free amino acid concentrations are also altered in people with high visceral obesity [7]; alanine (Ala), glutamate (Glu), phenylalanine (Phe), proline (Pro), tryptophan (Trp) and tyrosine (Tyr) are elevated, while glycine (Gly) and serine (Ser) are decreased. It is believed that this alteration is caused by a combination of insulin resistance-induced accelerated protein break down in muscle and changes in the gluconeogenesis set point in liver.

point in liver. On the other hand, insufficient protein intake could trigger low concentrations of essential and semi-essential amino acids in blood [4,5]. Insufficient protein intake, which is called protein malnutrition, is common across varying populations, particularly in elderly subjects. It has been associated with increased risk of sarcopenia, heart failure, impaired immune response, impaired respiratory function, delayed wound healing, overall increased complications and increased mortality in various populations [17-19]. Especially, the importance of ingesting enough amount of protein is demonstrated in the elderly population [20]. Furthermore, in generally healthy population who go to annual health checkup, low essential and semi-essential amino acid concentrations in blood was significantly associated with the protein malnutrition-associated markers, anemia-associated markers, sympathetic nerve activity-associated markers, and inflammation and immune function-associated markers [6,21]

Although, the measurement of PFAAs to evaluate the risk of overnutrition and protein malnutrition is potentially useful, social implementation involves several difficulties. The fasting blood has to be collected in the morning in hospitals with strict sample management to keep metabolites stable, and the blood has to be transported to the site where centrifugation can be done for plasma preparation. The rigorous measurement of PFAAs requires high-performance liquid chromatography– electrospray ionization mass spectrometry followed by precolumn derivatization [21-26]. Thus, we hypothesized that if the results of a simple questionnaire for lifestyle habits could be correlated to PFAA concentrations, then this could be used as an initial screening tool for PFAA alterations.

In this study, we designed a lifestyle habits questionnaire associated with overnutrition and protein malnutrition, suitable for Japanese rural community dwellers. And then, we quantified PFAA concentrations and investigated the association with the results of lifestyle habits questionnaire in 1,764 participants.

 

MATERIALS AND METHODS

Participants

The study was conducted in accordance with the Declaration of Helsinki, and the protocol was approved by the Saihaku Hospital (Tottori, Japan). A total of 2,809 Japanese participants who visited Saihaku Hospital from January 2012 to June 2014 were enrolled. All participants were generally healthy and at least 20 years of age (mean age: 62.9 ± 11.1 years) (Table 1). Exclusion criteria included pregnancy, severe mental disorders, and cancer

The lifestyle habits questionnaire

The lifestyle habits questionnaire with 19 items was used to assess the dietary habits, alcohol consumption, sleeping habits, physical activity and body weight change (Table 2) [27-37], which was optimized for the lifestyle of Japanese rural community dwellers. Q.1, Q.2, Q.3, Q.4, Q.5, Q.6, and Q.7 are related with overnutrition lifestyle habits, while Q.15, Q.16, Q.17, Q.18 and Q.19 are related with protein malnutrition lifestyle. Q. 8, Q. 9, Q.10, Q. 11, Q. 12, Q. 13 and Q. 14 are related with sleep duration, frequency to intake dairy food, snack habit, gait speed, fruit and vegetable intake. The questionnaire survey was conducted via mail from August 2014 to September 2014. The participants answered using two scales (Yes/No) to the each question. Finally, 1,764 participants (62.8% response rate) delivered a completed questionnaire.

Measurement of plasma free amino acid concentrations

At Saihaku Hospital, blood samples (5 mL) were collected from forearm veins after overnight fasting into tubes containing disodium ethylenediaminetetraacetate (2Na·EDTA) that were immediately placed on ice. Plasma was prepared by centrifugation at 3,000 rpm at 4 for 15min. The plasma amino acid concentrations were measured by high-performance liquid chromatography–electrospray ionization mass spectrometry followed by precolumn derivatization as previously described [22-26]. The following 21 amino acids were measured: Ala, arginine (Arg), asparagine (Asn), citrulline (Cit), Glu, glutamine (Gln), Gly, histidine (His), isoleucine (Ile), leucine (Leu), lysine (Lys), methionine (Met), ornithine (Orn), Phe, Pro, Ser, threonine (Thr), tryptophan (Trp), Tyr, valine (Val), and α-Amino butyric acid (αABA).

Statistical analyses

The statistical analyses except for the estimation of linear regression models were performed using the JMP 13.2.1 program (SAS Institute Inc., Cary, NC, USA). Welch’s t-tests were used to compare male and female. Categorical data were analyzed using chi-square test. The data in the tables are expressed as the mean ± SE.

Relationship between plasma free amino acid concentrations and answer of each question (Yes = 1, No = 0) was evaluated in terms of sex-adjusted standardized partial regression coefficients. The R language (R version 3.2.4 Revised, http://www.r-project. org/) was implemented for the estimation of linear regression models. Statistical significance was set at P<0.05.

 

RESULTS AND DISCUSSION

ESULTS AND DISCUSSION We generated the lifestyle habits questionnaire which is suitable for Japanese rural community dwellers to evaluate the overnutrition and protein malnutrition. This study demonstrated the questions regarding overnutrition and protein malnutrition had association with some of PFAA profiles in 1,764 Japanese participants, and thus, it could be a potential screening tool to evaluate the PFAA profiles.

Table (1) represents the demographics and plasma free amino acid profiles of the participants. The plasma amino acid concentrations were significantly higher in male than in female, except for Gly and Ser, and these concentrations were within the reference intervals for plasma amino acid concentrations in generally healthy Japanese subjects [21]. Table (2) shows the lifestyle habits questionnaire, and Table (3) indicates the number and percent of participants who responded “Yes” to each question. The ratio of the participants who responded “Yes” to Q.1, Q.5, Q.9, Q.12, Q.13 and Q.18 were significantly higher in male than female, while Q.7 and Q.10 were significantly lower in male. Decrease in PFAA concentrations might be causality or result of loss of appetite. Further clarification would be needed

There are two limitations in this study. The populations in this study were community dwellers who lived in a rural Japanese area and most of them are elderly. This specific population and locality could be a bias for the result. Some questions regarding sleep duration, frequency to intake dairy food, snack habit, gait speed, fruit and vegetable intake such as Q. 8, Q. 9, Q. 10, Q. 11, Q. 12, Q. 13 and Q. 14 had little impact to PFAA profiles. This might be related to the specific lifestyle of Japanese rural community dwellers. Comparison with other populations with different ages and areas are necessary. The second limitation is lack of other blood biochemical variables, medical information, and rigorous nutritional intake records in these participants. In this study, only plasma amino acid concentrations and answers to the questionnaire were available. Although the multiple analyses performed in the study demonstrated a significant relationship between PFAAs and lifestyle questionnaire, further clarification how other possible factors affected the results are to be demonstrated in the future.

 

Table 1: Demographic and plasma free amino acid concentrations.

  Male Female P
N 755 1009  
Age (y) 66.0 ± 0.4 64.6 ± 0.3  
  Amino acids (μmol/L    
αABA 20.1 ± 0.2 18.4 ± 0.2 ***
Ala 361.6 ± 2.8 308.8 ± 2.2 ***
Arg 101.2 ± 0.6 92.8 ± 0.5 ***
Asn 47.2 ± 0.2 42.9 ± 0.2 ***
Cit 33.7 ± 0.3 31.3 ± 0.2 ***
Gln 602.4 ± 2.7 585.8 ± 2.0 ***
Glu 32.0 ± 0.5 23.7 ± 0.3 ***
Gly 208.1 ± 1.6 237.0 ± 2.2 ***
His 80.8 ± 0.3 76.0 ± 0.3 ***
Ile 66.0 ± 0.5 50.3 ± 0.3 ***
Leu 128.5 ± 0.7 102.8 ± 0.5 ***
Lys 202.5 ± 1.1 183.9 ± 0.8 ***
Met 27.2 ± 0.2 22.6 ± 0.1 ***
Orn 53.7 ± 0.5 48.5 ± 0.4 ***
Phe 60.4 ± 0.3 53.4 ± 0.2 ***
Pro 149.0 ± 1.5 117.4 ± 1.1 ***
Ser 107.6 ± 0.6 111.0 ± 0.7 ***
Thr 130.3 ± 1.0 115.6 ± 0.8 ***
Trp 57.1 ± 0.3 49.5 ± 0.2 ***
Tyr 66.5 ± 0.4 57.9 ± 0.3 ***
Val 230.6 ± 1.3 195.3 ± 1.0 ***

 

The continuous variables are summarized as means ± standard error (SE). Significant differences between male and female are shown as *P<0.05, **P<0.01, ***P<0.001 according to Welch's t-test

 

Table 2: Lifestyle habits questionnaire.

Q.1 I have gained more than 10 kg of body weight compared with 20 years ago (or when I was 18 years old).
Q.2 I usually eat fast and do not stop eating until I become full
Q.3 I eat most of the meal at dinner or have a habit of eating a midnight snack
Q.4 I try to limit the amount to eat.
Q.5 I often eat fatty meat such as bacon and sausage.
Q.6 I often eat meals less than 2 times a day.
Q.7 I tend to sit down rather than get up and work during free time, or I do not like exercise.
Q.8 I sleep for less than 5 hours a day
Q.9 I eat dairy food and drink milk less than 3 times a week.
Q.10 I have a habit of eating snacks
Q.11 I walk slower compared with others who are in the same sex and the same generations.
Q.12 I rarely eat fruits
Q.13 I eat vegetables less than 350g or 5 dishes a day. *1 dish corresponds a small bowl or a side dish
Q.14 As a staple food, I eat refined grains such as white rice or white bread rather than unrefined brown rice. (Refined grains include white rice, white bread, udon, and ramen noodle, while unrefined grains include brown rice, rye, millet bread, and buckwheat noodles.)
Q.15 On average, I eat meats less than 1 time a day.
Q.16 On average, I eat seafood less than 1 time a day.

 

Table 3: The percent of subjects who answered “Yes” to the lifestyle questionnaire.

  All N (%) Male N (%) Female N (%) P   All N (%) Male N (%) Female N (%) P
Q.1 551 (31.5%) 297 (39.7%) 254 (25.3%) *** Q.11 486 (27.7%) 215 (28.6%) 271 (27.0%)  
Q.2 482 (27.6%) 209 (27.8%) 273 (27.4%)   Q.12 626 (35.8%) 326 (43.6%) 300 (29.9%) ***
Q.3 211 (12.1%) 81 (10.9%) 130 (13.1%)   Q.13 1057 (60.5%) 486 (65.1%) 571 (57.2%) ***
Q.4 539 (30.7% 218 (29.1%) 321 (32.0%)   Q.14 1516 (86.5%) 648 (86.4%) 868 (86.6%)  
Q.5 311 (17.8%) 170 (22.6%) 141 (14.1%) *** Q.15 1188 (68.1%) 525 (69.8%) 663 (66.8%)  
Q.6 127 (7.2%) 63 (8.4%) 64 (6.4%)   Q.16 884 (50.6%) 372 (49.5%) 512 (51.5%)  
Q.7 671 (38.4%) 263 (35.0%) 408 (41.0%) * Q.17 119 (6.8%) 49 (6.5%) 70 (7.0%)  
Q.8 232 (13.2%) 93 (12.4%) 139 (13.9%)   Q.18 234 (13.5%) 187 (25.3%) 47 (4.7%) ***
Q.9 502 (28.6%) 275 (36.5%) 227 (22.7%) *** Q.19 62 (3.5%) 19 (2.5%) 43 (4.3%) 0.0503
Q.10 924 (52.8%) 304 (40.4%) 620 (62.1%) ***          

The categorical variables are shown as frequencies and proportions. Significant differences between male and female are shown as *P<0.05, **P<0.01, ***P<0.001 according to chi-square test.

 

Table 4: Sex-adjusted P-values of standardized partial regression coefficients between each PFAA concentration and the lifestyle-related question.

  Val Ile Leu Phe Trp Tyr His αABA Glu Ala Met Thr Pro Lys Arg Ser Asn Gln n Orn Gly Cit
Q.1 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 <0.001 0.246 0.826 0.172 0.96 0.023 0.001 <0.001
Q.2 <0.001 <0.001 <0.001 0.018 <0.001 0.007 0.004 0.068 <0.001 <0.001 0.001 <0.001 0.001 0.002 0.925 0.492 0.518 0.717 0.943 0.312 0.027
Q.3 0.029 0.03 0.084 0.089 0.001 0.003 0.27 0.479 0.04 0.007 <0.001 0.008 0.01 0.76 0.612  0.019 0.254 0.819 0.136 0.995 0.214
Q.4 <0.001  <0.001 <0.001 0.009 0.018 0.003 0.26 0.003 <0.001 0.302 0.069 0.016 0.018 0.008 0.598 0.142 0.685 0.638 0.156 0.106 0.928
Q.5 0.061 0.019 0.045 0.769 0.014 0.32 0.353 0.647 0.043 0.006 0.043 0.002 0.141 0.04 0.517 0.002 0.749 0.336 0.74 0.139 0.779
Q.6 0.599 0.279 0.938 0.672 0.016 0.804 0.799 0.015 0.319 0.1 0.472 <0.001 0.194 0.481 0.76 0.001 0.463 0.059 0.226 0.057 0.031
Q.7 0.143 0.01 0.34 0.774 0.432 0.03 0.39 0.484 <0.001 0.023 0.077 0.005 <0.001 0.845 0.59 0.36 0.123 0.329 0.511 0.675 0.168
Q.8 0.503 0.575 0.235 0.604 0.27 0.836 0.413 0.949 0.142 0.052 0.328 0.189 0.536 0.988 0.94 0.285 0.779 0.303 0.287 0.04 0.975
Q.9 0.422 0.914 0.557 0.294 0.763 0.079 0.469 0.008 0.95 <0.001 0.196 <0.001 <0.001 0.082 0.313 0.224 0.515 0.931 0.2 0.01 0.42
Q.10 0.633 0.32 0.609 0.637 0.08 0.496 0.881 <0.001 0.676 0.326 0.617 0.305 0.364 0.091 0.143 <0.001 0.087 <0.001 <0.001 0.684 0.411
Q.11 0.75 0.1 0.924 0.278 0.011 0.077 0.002 0.001 0.043 0.112 0.35 0.26 0.14 0.845 0.946 0.06 <0.00 0.229 0.782 0.343 0.011
Q.12 0.047 0.319 0.135 0.069 0.887 0.827 0.323 0.091 0.694 0.552 0.31 <0.001 0.3 0.033 0.356 0.138 0.989 0.016 0.116 0.874 0.77
Q.13 0.151 0.651 0.064 0.002 0.672 0.909 0.121 0.224 0.986 0.071 0.456 0.016 0.04 0.061  0.815 0.197 0.532 0.008 0.177 0.395 0.247
Q.14 0.025 0.116 0.096 0.611 0.519 0.166 0.106 0.014 0.515 0.144 0.869 0.469 0.119 0.329 0.459 0.998 0.185 0.335 0.001 0.523 0.938
Q.15 0.237 0.08 0.096 0.464 0.02 0.881 0.001 0.031 0.779 0.354 0.632 0.44 0.292 0.833 0.869 0.206 0.489 0.696 0.872 0.661 0.983
Q.16 0.024 0.608 0.025 0.078 0.069 0.008 0.18 0.019 0.078 0.3 0.218 0.001 0.312 0.022 0.36 0.533 0.366 0.183 0.684 0.974 0.128
Q.17 0.048 0.352 0.232 0.283 0.061 0.143 0.503 0.021 0.318 0.821 0.57 0.028 0.564 0.892 0.996 0.47 0.572 0.032 <0.001 0.005 0.079
Q.18 0.001 0.005 0.02 0.353 0.302 0.005 0.004 <0.001 0.438 0.392 0.802 0.001 0.069 <0.001 <0.001 <0.001 0.105 <0.001 0.29 0.635 <0.001
Q.19 0.003 0.187 0.005 0.001 <0.001 0.007 0.001 0.11 0.116 0.552 0.117 0.067 0.651 0.029 0.421 0.8 0.03 0.111 0.29 0.635 0.957

Significant association (P<0.01) between the lifestyle-related question and each PFAA are highlighted in grey.

 

 

CONCLUSION

In conclusion, the present study confirmed the association between the results of a lifestyle habits questionnaire and PFAA profiles. For simple checkup for PFAA alterations, this questionnaire could be a possible initial screening tool for Japanese rural community dwellers 

ACKNOWLEDGEMENTS

The authors’ responsibilities were as follows: KN, TA and OK designed the research; HJ, KN, YK, TM, MM and OK conducted the research; HJ, KN and AI analyzed the data; HJ, KN and TK wrote the paper; and TK had the primary responsibility for the final content. All the authors read and approved the final manuscript.

CONFLICT OF INTEREST

OK received research grants from Ajinomoto Co., Inc. HJ, KN, AI, YK, TM, MM and TA are employees of Ajinomoto Co., Inc. TK is a board member of Ajinomoto Co., Inc. The entire financial source was provided by Ajinomoto Co., Inc. No other potential conflicts of interest relevant to this article are declared.

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Jinzu H, Nagao K, Imaizumi A, Kageyama Y, Muramatsu T, et al. (2018) Association between Lifestyle Habits Questionnaire and Plasma Free Amino Acid Profile in Japanese Rural Community Dwellers. Ann Clin Exp Metabol 3(2): 1030.

Received : 20 Jul 2018
Accepted : 28 Aug 2018
Published : 30 Aug 2018
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JSM Regenerative Medicine and Bioengineering
ISSN : 2379-0490
Launched : 2013
JSM Spine
ISSN : 2578-3181
Launched : 2016
Archives of Palliative Care
ISSN : 2573-1165
Launched : 2016
JSM Nutritional Disorders
ISSN : 2578-3203
Launched : 2017
Annals of Neurodegenerative Disorders
ISSN : 2476-2032
Launched : 2016
Journal of Fever
ISSN : 2641-7782
Launched : 2017
JSM Bone Marrow Research
ISSN : 2578-3351
Launched : 2016
JSM Mathematics and Statistics
ISSN : 2578-3173
Launched : 2014
Journal of Autoimmunity and Research
ISSN : 2573-1173
Launched : 2014
JSM Arthritis
ISSN : 2475-9155
Launched : 2016
JSM Head and Neck Cancer-Cases and Reviews
ISSN : 2573-1610
Launched : 2016
JSM General Surgery Cases and Images
ISSN : 2573-1564
Launched : 2016
JSM Anatomy and Physiology
ISSN : 2573-1262
Launched : 2016
JSM Dental Surgery
ISSN : 2573-1548
Launched : 2016
Annals of Emergency Surgery
ISSN : 2573-1017
Launched : 2016
Annals of Mens Health and Wellness
ISSN : 2641-7707
Launched : 2017
Journal of Preventive Medicine and Health Care
ISSN : 2576-0084
Launched : 2018
Journal of Chronic Diseases and Management
ISSN : 2573-1300
Launched : 2016
Annals of Vaccines and Immunization
ISSN : 2378-9379
Launched : 2014
JSM Heart Surgery Cases and Images
ISSN : 2578-3157
Launched : 2016
Annals of Reproductive Medicine and Treatment
ISSN : 2573-1092
Launched : 2016
JSM Brain Science
ISSN : 2573-1289
Launched : 2016
JSM Biomarkers
ISSN : 2578-3815
Launched : 2014
JSM Biology
ISSN : 2475-9392
Launched : 2016
Archives of Stem Cell and Research
ISSN : 2578-3580
Launched : 2014
Annals of Clinical and Medical Microbiology
ISSN : 2578-3629
Launched : 2014
JSM Pediatric Surgery
ISSN : 2578-3149
Launched : 2017
Journal of Memory Disorder and Rehabilitation
ISSN : 2578-319X
Launched : 2016
JSM Tropical Medicine and Research
ISSN : 2578-3165
Launched : 2016
JSM Head and Face Medicine
ISSN : 2578-3793
Launched : 2016
JSM Cardiothoracic Surgery
ISSN : 2573-1297
Launched : 2016
JSM Bone and Joint Diseases
ISSN : 2578-3351
Launched : 2017
JSM Bioavailability and Bioequivalence
ISSN : 2641-7812
Launched : 2017
JSM Atherosclerosis
ISSN : 2573-1270
Launched : 2016
Journal of Genitourinary Disorders
ISSN : 2641-7790
Launched : 2017
Journal of Fractures and Sprains
ISSN : 2578-3831
Launched : 2016
Journal of Autism and Epilepsy
ISSN : 2641-7774
Launched : 2016
Annals of Marine Biology and Research
ISSN : 2573-105X
Launched : 2014
JSM Health Education & Primary Health Care
ISSN : 2578-3777
Launched : 2016
JSM Communication Disorders
ISSN : 2578-3807
Launched : 2016
Annals of Musculoskeletal Disorders
ISSN : 2578-3599
Launched : 2016
Annals of Virology and Research
ISSN : 2573-1122
Launched : 2014
JSM Renal Medicine
ISSN : 2573-1637
Launched : 2016
Journal of Muscle Health
ISSN : 2578-3823
Launched : 2016
JSM Genetics and Genomics
ISSN : 2334-1823
Launched : 2013
JSM Anxiety and Depression
ISSN : 2475-9139
Launched : 2016
Clinical Journal of Heart Diseases
ISSN : 2641-7766
Launched : 2016
Annals of Medicinal Chemistry and Research
ISSN : 2378-9336
Launched : 2014
JSM Pain and Management
ISSN : 2578-3378
Launched : 2016
JSM Women's Health
ISSN : 2578-3696
Launched : 2016
Clinical Research in HIV or AIDS
ISSN : 2374-0094
Launched : 2013
Journal of Endocrinology, Diabetes and Obesity
ISSN : 2333-6692
Launched : 2013
Journal of Substance Abuse and Alcoholism
ISSN : 2373-9363
Launched : 2013
JSM Neurosurgery and Spine
ISSN : 2373-9479
Launched : 2013
Journal of Liver and Clinical Research
ISSN : 2379-0830
Launched : 2014
Journal of Drug Design and Research
ISSN : 2379-089X
Launched : 2014
JSM Clinical Oncology and Research
ISSN : 2373-938X
Launched : 2013
JSM Bioinformatics, Genomics and Proteomics
ISSN : 2576-1102
Launched : 2014
JSM Chemistry
ISSN : 2334-1831
Launched : 2013
Journal of Trauma and Care
ISSN : 2573-1246
Launched : 2014
JSM Surgical Oncology and Research
ISSN : 2578-3688
Launched : 2016
Annals of Food Processing and Preservation
ISSN : 2573-1033
Launched : 2016
Journal of Radiology and Radiation Therapy
ISSN : 2333-7095
Launched : 2013
JSM Physical Medicine and Rehabilitation
ISSN : 2578-3572
Launched : 2016
Annals of Clinical Pathology
ISSN : 2373-9282
Launched : 2013
Annals of Cardiovascular Diseases
ISSN : 2641-7731
Launched : 2016
Journal of Behavior
ISSN : 2576-0076
Launched : 2016
Clinical Research in Infectious Diseases
ISSN : 2379-0636
Launched : 2013
JSM Microbiology
ISSN : 2333-6455
Launched : 2013
Journal of Urology and Research
ISSN : 2379-951X
Launched : 2014
Journal of Family Medicine and Community Health
ISSN : 2379-0547
Launched : 2013
Annals of Pregnancy and Care
ISSN : 2578-336X
Launched : 2017
JSM Cell and Developmental Biology
ISSN : 2379-061X
Launched : 2013
Annals of Aquaculture and Research
ISSN : 2379-0881
Launched : 2014
Clinical Research in Pulmonology
ISSN : 2333-6625
Launched : 2013
Journal of Immunology and Clinical Research
ISSN : 2333-6714
Launched : 2013
Annals of Forensic Research and Analysis
ISSN : 2378-9476
Launched : 2014
JSM Biochemistry and Molecular Biology
ISSN : 2333-7109
Launched : 2013
Annals of Breast Cancer Research
ISSN : 2641-7685
Launched : 2016
Annals of Gerontology and Geriatric Research
ISSN : 2378-9409
Launched : 2014
Journal of Sleep Medicine and Disorders
ISSN : 2379-0822
Launched : 2014
JSM Burns and Trauma
ISSN : 2475-9406
Launched : 2016
Chemical Engineering and Process Techniques
ISSN : 2333-6633
Launched : 2013
Annals of Clinical Cytology and Pathology
ISSN : 2475-9430
Launched : 2014
JSM Allergy and Asthma
ISSN : 2573-1254
Launched : 2016
Journal of Neurological Disorders and Stroke
ISSN : 2334-2307
Launched : 2013
Annals of Sports Medicine and Research
ISSN : 2379-0571
Launched : 2014
JSM Sexual Medicine
ISSN : 2578-3718
Launched : 2016
Annals of Vascular Medicine and Research
ISSN : 2378-9344
Launched : 2014
JSM Biotechnology and Biomedical Engineering
ISSN : 2333-7117
Launched : 2013
Journal of Hematology and Transfusion
ISSN : 2333-6684
Launched : 2013
JSM Environmental Science and Ecology
ISSN : 2333-7141
Launched : 2013
Journal of Cardiology and Clinical Research
ISSN : 2333-6676
Launched : 2013
JSM Nanotechnology and Nanomedicine
ISSN : 2334-1815
Launched : 2013
Journal of Ear, Nose and Throat Disorders
ISSN : 2475-9473
Launched : 2016
JSM Ophthalmology
ISSN : 2333-6447
Launched : 2013
Journal of Pharmacology and Clinical Toxicology
ISSN : 2333-7079
Launched : 2013
Annals of Psychiatry and Mental Health
ISSN : 2374-0124
Launched : 2013
Medical Journal of Obstetrics and Gynecology
ISSN : 2333-6439
Launched : 2013
Annals of Pediatrics and Child Health
ISSN : 2373-9312
Launched : 2013
JSM Clinical Pharmaceutics
ISSN : 2379-9498
Launched : 2014
JSM Foot and Ankle
ISSN : 2475-9112
Launched : 2016
JSM Alzheimer's Disease and Related Dementia
ISSN : 2378-9565
Launched : 2014
Journal of Addiction Medicine and Therapy
ISSN : 2333-665X
Launched : 2013
Journal of Veterinary Medicine and Research
ISSN : 2378-931X
Launched : 2013
Annals of Public Health and Research
ISSN : 2378-9328
Launched : 2014
Annals of Orthopedics and Rheumatology
ISSN : 2373-9290
Launched : 2013
Journal of Clinical Nephrology and Research
ISSN : 2379-0652
Launched : 2014
Annals of Community Medicine and Practice
ISSN : 2475-9465
Launched : 2014
Annals of Biometrics and Biostatistics
ISSN : 2374-0116
Launched : 2013
JSM Clinical Case Reports
ISSN : 2373-9819
Launched : 2013
Journal of Cancer Biology and Research
ISSN : 2373-9436
Launched : 2013
Journal of Surgery and Transplantation Science
ISSN : 2379-0911
Launched : 2013
Journal of Dermatology and Clinical Research
ISSN : 2373-9371
Launched : 2013
JSM Gastroenterology and Hepatology
ISSN : 2373-9487
Launched : 2013
TEST Journal of Dentistry
ISSN : 1234-5678
Launched : 2014
Annals of Nursing and Practice
ISSN : 2379-9501
Launched : 2014
JSM Dentistry
ISSN : 2333-7133
Launched : 2013
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